Summary

A collection of serous fluid between the layers of the membrane (tunica vaginalis) that surrounds the testis or along the spermatic cord. Rarely, similar fluid collection can occur in females along the canal of Nuck.

Common in male infants and the newborn. Most pediatric hydroceles are congenital and, in the majority of cases, resolve within the first year of life.

May occur in adult men where they are found secondary to minor trauma, infection, testicular torsion, epididymitis, varicocele operation, or testicular tumor.

The main symptom is a painless, swollen scrotum on 1 or both sides, which feels like a water-filled balloon.

Treatment depends on the age of the patient and the degree of discomfort caused by the hydrocele. Surgery will only be performed if the hydrocele is causing problems.

Definition

Hydrocele is a collection of serous fluid between the layers of the membrane (tunica vaginalis) that surrounds the testis or along the spermatic cord. Rarely, similar fluid collection can occur in females along the canal of Nuck. There are 2 types of hydroceles: communicating and noncommunicating (simple).

In communicating hydroceles, a patent processus vaginalis connects the peritoneum with the tunica vaginalis, which allows peritoneal fluid to flow freely between both structures.
[Figure caption and citation for the preceding image starts]:
Communicating hydrocele
Created by the BMJ Group [Citation ends].
If the connection is large, abdominal contents (bowel, bladder, or omentum) may enter the groin, and this complication is termed an inguinal hernia. Inguinal hernias are classified into either direct or indirect, based on the relationship of the sac to the inferior epigastric artery. In a direct inguinal hernia, the hernial sac lies medial to the artery and the deep inguinal ring. In an indirect inguinal hernia, the hernial sac lies lateral to the artery (see our full content on inguinal hernia).
[1]International Pediatric Endosurgery Group. IPEG guidelines for inguinal hernia and hydrocele. J Laparoendosc Adv Surg Tech A. 2010;20:x-xiv.
http://www.ipeg.org/hernia/
http://www.ncbi.nlm.nih.gov/pubmed/20230241?tool=bestpractice.com

A noncommunicating or simple hydrocele occurs when the processus vaginalis is closed and more fluid is being produced by the tunica vaginalis than is being absorbed.
[Figure caption and citation for the preceding image starts]:
Noncommunicating hydrocele
Created by the BMJ Group [Citation ends].